Optimizing the nipple-areola sparing mastectomy with double concentric periareolar incision and biodimensional expander-implant reconstruction: Aesthetic and technical refinements

Although the biodimensional anatomical expander-implant system (BEIS) is a reliable technique, little information has been available regarding outcome following nipple-areola sparing mastectomy (NSM). To perform the resection of glandular tissue, while improving the surgical access and maintaining the nipple-areola vascularization we have developed a new approach for NSM based on the double concentric periareolar incision (DCPI). The purpose of this study is to analyze the feasibility, surgical planning and its outcome following NSM. 18 patients underwent NSM reconstructions. Mean time of follow-up was 29 months. The technique was indicated in patients with small/moderate volume breasts. Flap complications were evaluated and information on aesthetic results and patient satisfaction were collected. 83.3% had tumors measuring 2 cm or less (T1) and 72.1% were stage 0 and 1. All patients presented peripherally tumors located (at least 5 cm from the nipple). Skin complications occurred in 11.1%. One patient (5.5%) presented small skin necrosis and a wound dehiscence was observed in one patient (5.5%). The aesthetic result was good/very good in 94.4 percent and the majority of patients were very satisfied/satisfied. No local recurrences were observed. All complications except one were treated by a conservative approach. DCPI-BEIS is a simple and reliable technique for NSM reconstruction. The success depends on patient selection, coordinated planning with the oncologic surgeon and careful intra-operative and post-operative management. (C) 2009 Elsevier Ltd. All rights reserved.

Mastication effort study using photorefractive holographic interferometry technique

The purpose of this work was the force-displacement response analysis of the masticatory process in a dried human skull by Double-Exposure Photorefractive Holographic Interferometry Technique (2E-PRHI). The load concentration and dissipation of the forces from dried human skull were analysed at applied loading stands as a Simulation of Isolated Contraction (SIC) of some mastication muscles. The 2EHI and Fringe Analysis Method were used to obtain the quantitative results of this force-displacement response. These results document quantitatively the real biomechanical response from dried human skull under applied loading and it can be used for complementary study by finite element model and others analysis type. Crown Copyright (C) 2009 Published by Elsevier Ltd. All rights reserved.